Understanding Dissociative Disorders: Symptoms, Causes, and Effective Treatments

What are Dissociative Disorders?

Dissociative disorders are a group of mental health conditions that involve a disconnection or separation from one’s thoughts, feelings, or experiences. These disorders can be caused by traumatic events, stress, or other factors that affect an individual’s ability to cope with their emotions and memories. Dissociative disorders can manifest in different ways, including dissociative amnesia, dissociative fugue, depersonalisation disorder, and dissociative identity disorder.

A senior clinical psychologist may use a range of evidence based therapies to help individuals manage their dissociative symptoms and develop coping strategies. These therapeutic approaches aim to provide a deeper understanding of the function of dissociation, and give the individual greater control over their symptoms.

Causes and Risk Factors of Dissociative Disorders

Dissociative disorders frequently stem from enduring trauma and relentless stress. Persistent abuse in childhood is a strong risk factor, which may involve physical, sexual, or emotional abuse. 

Other experiences like warfare, natural disasters, and violent crime are also known to trigger dissociative disorders including post traumatic stress disorder. Significant traumas such as these can overwhelm the psyche to an extent where disassociation becomes a survival strategy.

Types of Dissociative Disorders

There are three primary types of dissociative disorders: dissociative identity disorder, dissociative amnesia, and depersonalisation/derealisation disorder. All of these conditions involve significant disruptions to memory, sense of self, or perception. 

Known in previous editions of the Diagnostic and Statistical Manual as multiple personality disorder, Dissociative Identity Disorder (DID) is characterised by an individual exhibiting two or more distinct personalities or identities. These varying personality states often have unique names, ages, histories and characteristics and usually develop as a mechanism to cope with severe trauma.

The primary feature of Dissociative Amnesia is the substantial inability to recall key personal information—usually concerning traumatic or stressful experiences—that cannot be explained by typical forgetfulness. The extent of this memory loss can severely impact one’s understanding and connection with their own personal history.

Those suffering from Depersonalisation/Derealisation Disorder experience ongoing feelings that either they themselves are outside observers looking at their lives without feeling connected (depersonalisation), or that everything around them seems unreal—like living inside a dream—with familiar surroundings appearing foreign (derealisation).

Dissociative Identity Disorder (DID)

Dissociative identity disorder stands as one of the most intricate and frequently misconstrued conditions among mental health disorders, including various forms of mental illness. This condition is characterised by an individual exhibiting two or more distinct personalities, each possessing its unique way of understanding and engaging with their surroundings. These multiple identities or “alters” may intermittently dominate the person’s actions, causing substantial memory lapses and confusion over their own identity. Comprehensive evaluations, which assess for a wide range of mental health domains (including ADHD assessments for example), may be conducted to understand the full scope of an individual’s mental health needs.

The manifestation of DID symptoms can significantly differ in terms of intensity. While some may encounter abrupt and pronounced transitions between these alters, for others, such shifts might be less apparent and more challenging to discern. Often emerging as a psychological response to severe trauma. DID has a functional means for individuals which is to detach themselves from intense distressing experiences emotionally.

Navigating daily life while managing dissociative identity disorder poses considerable challenges due to the unpredictable nature of alternating personas which complicates sustaining consistent relationships and self-identity. Nevertheless, given appropriate care alongside therapeutic interventions tailored specifically for those affected by DID, it permits them not just stability but also opens avenues toward living enriching lives despite their diagnosis.

Depersonalisation/ Derealisation Disorder

Depersonalisation/derealisation disorder manifests as persistent feelings of being detached from oneself or one’s environment. People who suffer from this condition often experience a sensation of watching themselves from an external perspective (depersonalisation) or perceive the world around them to be surreal, akin to a dream state (derealisation).

The duration and frequency of these episodes can vary greatly. They may be brief but have the potential to stretch on for hours or days. Such prolonged experiences can significantly disrupt daily activities and hinder one’s ability to form and maintain personal connections.

Dissociative Amnesia and Fugue

Dissociative amnesia is characterised by substantial memory loss that pertains to personal information or historical occurrences, frequently as a result of traumatic experiences. This condition is more significant than everyday “forgetfulness.” It represents an intense absence of recall which may persist from moments up to multiple years.

Another related disorder is dissociative fugue, which falls under the broader category of dissociative amnesia. In this state, affected persons might embark on unforeseen journeys or stray from their residences while adopting new personas and completely losing touch with their former selves. Such episodes are both confusing and terrifying for those undergoing them, as well as for their families and friends.

It is important to understand these disorders in order to offer appropriate support and therapeutic interventions. By acknowledging the indications associated with dissociative amnesia and fugue states, assistance can be provided aiding sufferers in reclaiming governance over their identities and recollections.

Symptoms and Diagnosis

The symptoms of dissociative disorders can vary depending on the specific condition. Common symptoms include:

• Memory lapses or gaps in memory

• Feeling disconnected from oneself or the world around them

• Difficulty recalling important information or events

• Feeling like one is observing oneself from outside their body

• Experiencing different identities or personalities

Diagnosing dissociative disorders can be challenging, as the symptoms can be similar to those of other mental health conditions. A clinical psychologist may use a combination of psychological assessments, interviews, and observations to diagnose dissociative disorders. This comprehensive approach ensures that the diagnosis is accurate and that the treatment plan is tailored to the individual’s unique needs.

The Role of Complex Trauma in Dissociative Disorders

Dissociative disorders frequently arise as a consequence of trauma. As a coping mechanism, dissociation allows people to detach themselves mentally from situations that are exceedingly stressful or traumatic. This may interfere with how consciousness, memory, identity, and emotion work together seamlessly, resulting in significant challenges when it comes to everyday activities. It’s not unusual for individuals diagnosed with dissociative disorders to also suffer from related psychological problems like PTSD (post-traumatic stress disorder), anxiety issues, depression, and eating disorders.

Cognitive Behaviour Therapy and Other Treatment Options for Dissociative Disorders

Engaging in psychotherapy can be hugely beneficial when managing dissociative disorders, including dissociative identity disorder. Working with a mental health professional adept at treating these conditions facilitates open dialogue about the disorder and its effects on an individual’s life. The therapeutic journey typically extends over a long period and concentrates on reducing symptoms while processing past traumas. An important aspect of comprehensive therapeutic approaches is addressing sexual health concerns, which can significantly impact overall well-being.

Therapies aimed at stabilising symptoms and increasing emotional regulation, as well as processing trauma, have been found to be beneficial in managing and treating dissociative disorders. These therapies include:

• Cognitive Behavioural Therapy (CBT)

• Dialectical Behaviour Therapy

• Acceptance and Commitment Therapy (ACT)

• Mindfulness based therapies

• Schema Therapy

• Eye Movement Desensitisation Reprocessing (EMDR)

Often a range of these approaches are employed to work on dissociative disorders. Building a foundation of trust between patient and therapist is fundamental and allows for safe trauma processing therapy to occur.

Personalising treatment approaches according to each person’s unique experiences of their dissociative disorder enhances the potential effectiveness of professional intervention. Therapists then become better equipped to assist individuals not only in grasping the roots behind their condition, but also in adopting practical tactics for symptom management going forward.

Medication and Therapy for Dissociative Disorders

Although no pharmacological treatments are exclusively developed for dissociative disorders, the use of antidepressants and anti-anxiety drugs may lessen associated mental health symptoms such as depression and anxiety. Mental health professionals might recommend these medications to manage particular symptoms linked with treating dissociative identity disorder.

Adopting an integrated care model that combines both pharmaceutical intervention and talk therapy may enhance treatment outcomes, enabling those affected to achieve greater stability and fulfilment in their lives. We recommend that our clients explore the option of medication with their doctor.

Coping Strategies and Support Systems for Mental Health Conditions

Creating a robust network of support is often important for those dealing with dissociative disorders. Joining peer support groups can offer a community feeling and reduce the sense of isolation one might experience. Utilising grounding methods, like mindfulness practices, could assist in re-establishing a connection to the current moment and diminishing symptoms of dissociation.

Developing consistent daily routines can bring stability and consistency, potentially easing the disorientation that often accompanies dissociative disorders. Mental health experts typically suggest integrating such strategies into everyday life as they may help in symptom management and enhance overall well-being.

Living with Dissociative Disorders

Living with dissociative disorders can be challenging, but with the right treatment and support, individuals can learn to manage their symptoms and improve their mental health. A therapist in Melbourne can work with individuals to develop coping strategies, such as stress management techniques, grief counselling, and cognitive behaviour therapy.

In addition to therapy, individuals with dissociative disorders may benefit from support groups, self-care activities, and education about their condition. It’s essential to work with a mental health professional, such as a senior clinical psychologist, to develop a treatment plan that addresses the individual’s specific needs and goals.

By seeking help and support, individuals with dissociative disorders can work towards lasting and meaningful change, improving their mental health and overall well-being. With the guidance of a clinical psychologist, they can navigate the complexities of their condition and find effective ways to lead fulfilling lives.

Therapist Melbourne: How We Can Help at Cova Psychology

If you think you may be experiencing dissociation, we recommend assessment from a trained mental health professional. Our Melbourne therapists, psychologists, and clinical psychologists are passionate about working with trauma and dissociation. Our psychology practice is located in the Melbourne CBD and we also provide psychological assessment and treatment via telehealth.

Don’t hesitate to reach out to our warm reception team who can get to know your needs and match you with a Melbourne psychologist.